D.C. Mun. Regs. tit. 29, r. 29-7301
An applicant shall apply for the Immigrant Children's Program by submitting to the Department an application form designated by the Department, which may be found online athttps://dhcf.dc.gov/service/how-apply-medical-coverage. The application form may be submitted to the Department:
The application and any required verification may be submitted by:
When determining eligibility, the Department shall, where possible, determine eligibility using available electronic information.
Where the Department requires additional information to determine eligibility, the Department shall provide written notice to the applicant or beneficiary that includes a statement of the specific information needed to determine eligibility and the date by which an applicant or beneficiary shall provide the required information.
The Department shall issue an eligibility determination, consistent with the timeframe described under § 7301.9 based on the receipt of an application that includes, at a minimum:
The applicant shall complete the following application process in order for the Department to determine whether the applicant meets the eligibility factors for the Immigrant Children's Program:
An application shall be considered complete if all of the following requirements are met:
The Department shall use the date an application is received by the Department, as described under § 7301.5, to determine the earliest date for which medical assistance under the Immigrant Children's Program can be effective, consistent with the enrollment requirements described under § 7305.1.
The Department shall issue written notice within forty-five (45) calendar days of the date an application is received by the Department. The Department may extend the forty-five (45) day period pursuant to DC Official Code § 4-205.26 when a delay is caused by unusual circumstances such as:
An applicant or an individual acting on an applicant's behalf may withdraw an application upon request, through a signed statement, and prior to an eligibility determination through the following means:
A beneficiary shall notify the Department within ten (10) calendar days of any change in circumstances that affects the beneficiary's eligibility to receive medical assistance in the Immigrant Children's Program.
The Department shall re-determine eligibility for beneficiaries identified at § 7301.11 at the time the change is reported.
Every twelve (12) months, beginning the first of the month that eligibility was previously approved, all Immigrant Children's Program beneficiaries shall renew eligibility by submitting a renewal form to the Department (either in person, by mail, online (including web-based portal), or through commonly available electronic means (including fax) or by completing the renewal telephonically).
The Department shall provide a renewal form to the beneficiary sixty (60) calendar days before the end of the certification period, with the date the beneficiary shall provide the requested information described in the renewal form in order to complete the renewal process (which may be through the modalities described in § 7301.13). The beneficiary shall provide the requested information at least thirty (30) days before the end of the certification period to avoid a lapse in coverage and to allow time for application processing, review, and an eligibility determination.
Where the Department provides a beneficiary with a renewal form to begin the renewal process, the beneficiary shall:
The renewal process shall be complete if all of the following requirements are met:
The Department shall issue a written notice of termination to the beneficiary if the beneficiary has not returned the renewal form or submitted a telephonic or online renewal, and the Department has not received all the information necessary to renew eligibility by the thirtieth (30th) calendar day before the end of the certification period.
Where a beneficiary has not completed the renewal process, as described under § 7301.17 by the end of the beneficiary's certification period, the beneficiary shall be given an additional ninety (90) calendar day grace period beyond the end of the beneficiary's certification period to submit the renewal form to the Department (in person, by phone, by mail, or through other commonly available electronic means) following the process outlined in § 7301.15. If the beneficiary submits the form and completes the renewal requirements under § 7301.15 during this grace period and if the Department determines the individual remains eligible, coverage shall be reinstated to the end of the certification period without interruption; and if the Department determines the individual ineligible for coverage, the Department shall issue a notice notifying the beneficiary that the beneficiary is no longer eligible for coverage.
The Department shall begin the termination process for Immigrant Children's Program eligibility in accordance with the requirements described in section 7307 when:
Upon receipt of a request for termination of eligibility by the beneficiary or the beneficiary's authorized representative in writing (including a written request submitted through mail, online, or other commonly available electronic means) or telephonically, the Department shall terminate the beneficiary's eligibility on:
A request to terminate Immigrant Children's Program eligibility shall be complete if all of the following requirements are met:
The Department shall provide written notice of termination and may waive the requirement that the notice be provided no later than fifteen (15) calendar days before the action, as stated under § 7307.5 through § 7307.6.
An applicant or beneficiary may designate someone to be an authorized representative to act on the individual's behalf and assist with an application, a redetermination of eligibility, and other on-going communications with the Department. The Department shall require the following:
D.C. Mun. Regs. tit. 29, r. 29-7301